Information Sheet Weight Accessible information about weight for adults with an eating disorder
? Why do I need to restore my body weight? Weight restoration in eating disorders is integral to recovery and long term physical and psychological well-being. Everyone s body is different and our healthy weight is influenced by our genetics. Just like your eye colour is decided by your genes so is the amount you should weigh. But we can, and do manipulate our weight through either restriction of food or over eating. By doing one or the other for a long period of time you have a negative effect on your physical health and psychological well-being. If you have had an eating disorder as an adolescent you may not know what your body s natural weight should be as an adult. Whilst you are unwell you may not be able to visualise yourself at a healthy weight. So what is wrong with manipulating my body weight? When we try to manipulate our weight by under or over eating we put pressure on our body s natural maintenance mechanisms. Although food availability has evolved, our drive to eat and survive has not; and if we start to move below our set weight our body will make adaptions to encourage us back to its safe weight and prevent weight loss. This is set point weight range. Most people will under and over eat by small amounts depending on the day and their metabolism will speed up and slow down to compensate. This will have very little impact on weight and shape and they will stay at their set point weight range. > Most people will under and over eat by small amounts depending on the day and their metabolism will speed up and slow down to compensate. 2
Set point weight is it really set? This is an important theory to get to know if you are restricting your dietary intake. As mentioned genetics will play a role in your determined height, hair colour etc. Just like this your body weight will have a natural weight it is designed to be. When you restrict your intake and start to lose weight, your body actions other mechanisms to encourage you to return to its set point weight range. These mechanisms will typically increase the feeling of hunger, turning thoughts to that of food (food preoccupation) and are designed to encourage dietary intake and will decrease metabolic turnover to slow down weight loss. Trying to keep your body at a weight below what it is meant to be will create a battle between your will and your body s mechanisms. An important point to note when weight restoring for recovery, is, that psychological input alone cannot change the thoughts about food and the hunger drive. Only your body being in its natural weight range can achieve this. In other words you cannot have psychological health without physical health. So what is a healthy weight? Your healthy weight is determined by using Body Mass Index (BMI). As an adult your healthy BMI range generally ranges between 20kg/m 2 and 25kg/m 2. As an adult your healthy BMI range generally ranges between 20kg/m 2 and 25kg/m 2. Working out your BMI Ages 18 and over Divide your weight by your height squared. Ages under 18 Then this is calculated based on your BMI Centile chart, which is dependent upon your age. 3
BMI is important as it takes in to consideration the amount of muscle, organ and fat tissue that a person needs to be healthy, protect their organs and ensure appropriate metabolic and hormonal activity in the body. If you have a high muscle mass then BMI may not be accurate, therefore, it will not be the only way to indicate your physical health. So how do I start working towards a healthy weight? Top tips: Discuss your target weight with your dietitian and wider team. It is important to establish the expectation of your weight gain journey. Set a target weight and agree your maintenance band. The maintenance band is often your target weight plus 1-2kgs this allows for your body weight to fluctuate due to hormonal and hydration changes that occur during the month. Set a weekly goal. This can be done with your dietitan. It is helpful to have a weekly expectation for weight gain. Typically we would recommend a gain of approximately 0.5kgs a week. Meal planning is integral to restoration of health. It sets realistic expectations. It also means that you don t have to think of things on the spot or won t have the right food available which can lead to things being missed. It can support you to be in control rather than your eating disorder. Include all the food groups. Often when people have been restricting their intake, some of the food groups can be missed. All food groups have vital roles in the body and without them there may be physical and psychological consequences. This means including regular sources of carbohydrates, proteins, dairy, fats, fruit and vegetables in your meal plan. 4
Conclusion Weight restoration when you have an eating disorder can be challenging, however it is necessary for both physical and psychological recovery. It is important that you seek support if needed. When considering weight gain, planning is key and agreed goals can help provide boundaries and guidance. Your dietitian can work with you to support you and to ensure that your intake is balanced and provides the vital nutrients that your body requires for both physical and psychological well-being. 5
First published: June 2017 Review Date: June 2020 www.dietitiansmentalhealthgroup.org.uk 6